The purpose of this International Research Scientist Development Award is to provide Dr. Elizabeth Stringer, Instructor in the Department of Obstetrics and Gynecology at the University of Alabama at Birmingham (UAB), with sufficient protected time to 1) develop a broad base of understanding in the theoretical aspects of clinical research; 2) gain practical experience in the conduct of methodologically-rigorous clinical research in the developing world, particularly in the area of contraception; and 3) develop expertise in decision analysis and outcomes research. These skills will be obtained in a systematic fashion, as outlined in this research career award application. Dr. Stringer will undertake Master's level coursework in the UAB School of Public Health, with a special emphasis on epidemiology, clinical trials design, and outcomes research. Under the direction of her mentors, Drs. Sten Vermund and Moses Sinkala, the candidate will conduct a randomized clinical trial of the intrauterine contraceptive device (IUD) versus "user-chosen" hormonal contraception among HIV-infected women in Lusaka, Zambia. The trial will be linked to the ongoing collaborative research activities of her mentors. The candidate will be primarily responsible for all aspects of the randomized trial, including protocol development, training, implementation, daily management, and analysis. This experience will provide her with valuable field expertise in the conduct of clinical research in the developing world. In the latter part of the award, under the direction of UAB faculty member Dr. Dwight Rouse, the candidate will develop a decision analysis model to describe the health effects and costs of the IUD and other contraceptive strategies in the developing world. Data collected from the randomized trial will be used to inform the model. The cumulative effect of this award will be to enable Dr. Stringer to compete successfully for NIH individual investigator funding, with an ultimate goal of helping to advance the health and status of women and their infants in the developing world.